Advance care planning is an ongoing process in which people explore and discuss their goals, values, and experiences related to the end of life, as well as their understanding of their health in order to guide future treatment considerations and choices. Ideally, conversations about these choices occur over a person’s lifetime and are revisited whenever there are significant changes in their health or social support system, or whenever their wishes change. In addition to ongoing conversations and exploration, advance care planning should also include documenting a person’s preferences through written tools such as advance directives and medical orders when appropriate.
An advance directive like Five Wishes allows you to guide important medical care decisions that might be made if you ever get seriously ill – such as whether to give you life-support treatment. You may think that your loved ones and doctors will know what you want when you are very ill, but in reality, everyone has different wishes and it’s important to make them clearly known. Expressing your wishes in an advance directive like Five Wishes helps empower your family, friends, and doctor to make the best decisions when the time comes, and helps avoid disagreements about what to do. Completing the Five Wishes advance directive can help you and your loved ones gain peace of mind around these difficult decisions.
Aging with Dignity founder Jim Towey created Five Wishes with doctors, nurses, lawyers and other experts in end-of-life care to help people of all ages get the treatment they want if they become seriously ill. Jim is an attorney who served as legal counsel to Mother Teresa of Calcutta for 12 years until her death. He was a full-time live-in volunteer at her home for AIDS patients in Washington, DC. He learned that people are most concerned about maintaining their comfort and dignity when they are very sick. This is why the Five Wishes advance directive addresses the personal, emotional, and spiritual needs of a person, not just the medical and legal ones.
It was written with the help of the American Bar Association’s Commission on Law & Aging. It meets the legal requirements of 46 states, but is used widely in all 50, and a federal law requires medical care providers to honor patient wishes as expressed. See the advice on page 3 of the Five Wishes advance directive document. Just follow the directions when you sign it.
The Catholic Church supports the use of an advance directive, as long as the directive is not contrary to Church teaching, because it helps a person have his or her medical wishes respected and followed. Five Wishes and its companion guide for Catholics, Finishing Life Faithfully, have been endorsed by Cardinals, Archbishops, and bishops, including the chairman for the National Catholic Bioethics Center, Archbishop Gregory Aymond.
Physician-assisted suicide is when a patient ends his or her life by self-administering a poisonous mixture of drugs provided by a physician. Euthanasia is when a physician directly administers poisonous drugs to a patient or withholds life-saving treatment with the intention of bringing about the death of that patient. In other words, in physician-assisted suicide, the physician is an accomplice to the patient’s act of killing themself; in euthanasia, the physician is the actor that kills the patient.
Physician-assisted suicide is legal in Oregon, Washington, Vermont, California, New Mexico, Montana, Maine, New Jersey, Hawaii, Colorado, and the District of Columbia. It is also legal in 10 countries.
Physician-assisted suicide was made constitutionally illegal in West Virginia through a ballot initiative in the 2024 election. West Virginia is currently the only state to make physician-assisted suicide expressly illegal.
No, physician-assisted suicide by definition is not safe because it always results in the death of a person. Moreover, the drugs used in physician-assisted suicide have been proven to cause seizures, vomiting, and other complications for patients as well as long-term adverse effects on the mental health of those who participate in the practice, such as physicians and family members.
The 3 main criteria for eligibility in physician-assisted suicide laws across the country are: one must 1) be 18 years or older, 2) have received a terminal prognosis of 6 months or less to live, and 3) be judged to have the mental capacity to make informed decisions. Though advocates for physician-assisted suicide claim that these are strict enough guardrails in place that limit eligibility to a small group of people, evidence shows that multiple states have prescribed poison to individuals who were not suffering from a terminal illness, but rather chronic diseases such as arthritis and diabetes. Furthermore, most people with disabilities are eligible under the legal criteria previously listed solely because without the proper care, their disability would render them terminal. Finally, every single state in which PAS is legal has amended at least one guardrail, which has both loosened eligibility criteria and caused the number of PAS deaths to increase every single year.
Supporters of physician-assisted suicide tend to fall into three groups. The first group is driven largely by empathy or ignorance of the key issues; they cannot bear to tell a suffering person who wants physician-assisted suicide that this desire, while understandable, is wrong. Otherwise, they simply have not looked closely at the subject and lack an overview of the key issues. The second group is smaller and typically consists of individuals who have seen or are experiencing tremendous suffering at the end of life. These individuals earnestly seek deliverance from their suffering, whether it be physical, mental, or spiritual. They believe physician-assisted suicide is their best way out. The third group is the smallest, but one of the most active and influential. They believe that suicide is a completely rational and even admirable act that all individuals should be empowered to make if they see fit. Members of this group include some of the pioneers of eugenics, euthanasia, and physician-assisted suicide.
Every person is born with innate dignity and should be celebrated as being an integral part of humanity, especially in times of suffering. If we give people the “right to die,” then we are communicating to others that life only has value up to a point, and that when things get tough or people become burdensome, suicide is the proper response. And of course, many instances of miraculous or inexplicable recovery exist. Thus, it is of the utmost importance to value life at every stage, instead of hastening death.
No, not everyone who is prescribed poisonous physician-assisted suicide drugs uses them. In fact, in 2022 out of the 1,328 people who were prescribed physician-assisted suicide drugs in California, over 30% ended up not using them, which means that hundreds of Californians have dangerous and untracked poison sitting at home.
It is much cheaper for insurance companies to pay for a patient’s one-time prescription for physician-assisted suicide, than to pay for long-term, life-saving treatment.
Though doctors go to great lengths to become experts in their field, this does not give them the ability to predict the future. In fact, Oregon data shows that multiple people outlived their six-month terminal prognosis, with one patient outliving it by over 5 years. Studies have even shown that physician prognosis at the end of life can have an accuracy rate of as low as 20%.
People understandably want to avoid pain and have autonomy at the end of their lives. However, by promoting physician-assisted suicide, people come to believe that they only have the choice of pain (unwanted/ineffective treatment) or poison (physician-assisted suicide/euthanasia). By legalizing physician-assisted suicide, we put aside other end-of-life treatment options such as good pain management, avoiding unwanted treatment, and other comfort care options that are meant to improve the life of the patient while maintaining their humanity, rather than eliminating the person altogether, which has never been the purpose of good medicine.
Yes, physician-assisted suicide is expressly contrary to the Hippocratic Oath which states, “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan.”
Yes, overwhelmingly so; the fact that this remains a common question shows the lengths to which physician-assisted suicide advocates have influenced public discourse with their advocacy. No matter how you define ‘slippery slope,’ it exists; from increasing annual deaths to the removal of guardrails to the lax enforcement of protocols.
Suffering is not the same as pain – one can be pain-free and still experience immense suffering due to mental distress. A sprained ankle or a bee sting cause the same amount of physiological impact on two people, yet one may hardy notice the pain while another may experience anxiety over it. As such, suffering is impossible to quantify. Nevertheless, no one should be forced to suffer severe pain, whether one is eight or eighty years old. With the advancement of painkillers and palliative care, pain is almost always treatable and patients can receive total, if not almost total relief from pain at the end of life. Finally – and this is critical – unbearable pain has never been even close to the main reason individuals choose PAS based on the annual reporting from Oregon and Washington.
First of all, some of the most zealous opponents of physician-assisted suicide legislation are disability rights organizations, many of which are considered “progressive.” That said, this question is a strawman. Yes, the world’s leading religions of Christianity, Islam, Hinduism, Buddhism, and Judaism (with over 6 billion adherents worldwide) oppose physician-assisted suicide on moral grounds. But the claim that “I ought to do what I want with my life, even if that means killing myself,” is also a moral claim. Accusing people practicing a specific religion of moralizing is hypocrisy. Life and death issues are moral issues, whether you like it or not—all claims are moral claims.